


The Dismissed Protocol

by Curator



Category: Star Trek: The Next Generation, Star Trek: Voyager
Genre: Episode: s01e25 This Side of Paradise, Episode: s02e01 The Child, Episode: s07e16-17 Workforce, Gen, Just friends — not a relationship, Mentioned: Katherine Pulaski, trigger warning: medical rights, trigger warning: pregnancy termination/potential pregnancy termination
Language: English
Status: Completed
Published: 2019-01-19
Updated: 2019-01-19
Packaged: 2019-10-12 12:48:38
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 4,399
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/17467868
Author URL: https://archiveofourown.org/users/Curator/pseuds/Curator
Summary: When Kathryn Janeway learns there is a mysterious protocol known only to Starfleet doctors, she is determined to find out more. If Beverly Crusher agrees to share the information, the two women might be able to work together to expose the secret.Note: Story is set six months after Endgame. Think of it as a crossover episode for these fabulously fierce women.





	The Dismissed Protocol

Admiral Hayes was concluding his remarks: “And, since Rede Brooks has been the only admiral we’ve wrangled out of Starfleet Medical in decades, we all know what his retirement means — there will be no admiral within these walls to tend to us! No one to ‘take a quick look’ at a possible concussion or hairline fracture after we’ve banged our heads and our hands against our desks from too much work. Oh, I know you’ll be happy to be rid of this bunch of old hypochondriacs called the Senior Admiralty, but we’re going to miss you around here. Thanks for everything, Rede.”

Like the others assembled in the ballroom, Admiral Kathryn Janeway raised her synthethol glass in a toast.

“Have you ever met Admiral Brooks?” Janeway’s seatmate asked.

“No,” Janeway replied, “but I do want to thank him for so many years of service to Starfleet.”

“Then do it now. The retirees usually leave pretty quickly after the speeches. Rumor is his hearing and vision are pretty bad, so be sure to speak loudly.”

Janeway nodded and made her way to the front of the room. It had been nearly six months since her promotion to Starfleet Command, and she had heard many stories about the ways Admiral Brooks had strengthened the medical corps, including a successful petition to increase the fleet of specialized medical starships. After shaking hands with those onstage with him, Admiral Brooks leaned heavily on a man Janeway assumed was his son due to their strong resemblance. They were making their way down a few stairs on the far side of the stage when Janeway approached them.

“It’s an honor to meet you, Admiral,” she said, speaking loudly and clearly as she extended her hand. “I’m Kathryn Janeway. I’ve had the good fortune to receive expert medical care from Starfleet doctors you supervised, including an Emergency Medical Hologram for whom I’m told you contributed programming. Thank you for your service to Starfleet.”

Admiral Brooks batted Janeway’s hand away, then leaned forward, squinting his eyes and angrily stabbing his index finger in the air.

“Katherine Pulaski, you old rabble-rouser!” he said indignantly. “You won’t enforce the Dismissed Protocol, but you‘ll come to dance at the funeral of my Starfleet career? What are you doing here? I thought you were dead!”

Janeway looked at Admiral Brooks’ son. “I’m sorry,” he said. “You can see why my dad is retiring.”

Janeway nodded and spoke even louder: “I’m Kathryn Janeway, sir. I believe you have me confused with someone else. I wish you the best on your retirement.”

Admiral Brooks pushed past Janeway and moved into the crowd. He was significantly more congenial in his brief discussions with other well-wishers. Janeway tilted her head, thinking.

***

“It’s a pleasure to receive a call from you, Admiral!” The EMH from Voyager seemed to nearly jump through Janeway’s computer screen with excitement.

“Thank you, Doctor. It’s good to see you, too.”

“Do you require a housecall?”

Janeway smiled. “No,” she said, “but I am calling on business, something I‘m curious about that may pertain to the medical side of Starfleet. Doctor, what is the Dismissed Protocol?”

He was silent. _Well, there’s a first_ , Janeway thought.

“Admiral,” the EMH said, his zeal much reduced, “if you don’t mind me asking, where are you?”

“I’m in my office at Starfleet Command.”

“Ah, then perhaps you can look it up there. Goodbye.”

The EMH moved to cut off the call, but Janeway spoke before he had a chance.

“Doctor, I already tried that. I left a luncheon two hours ago and have spent every moment since looking up this damned protocol and I can’t find a thing.”

“Have you asked anyone else?”

“No, I called you first.”

“Unfortunately, my programming won’t allow me to divulge the information you want,” the EMH said brusquely. “No flesh and blood Starfleet doctor will tell you either, so I suggest you apply your curiosity to a different topic.”

The screen went dark. The EMH had ended the conversation.

 _All right_ , Janeway thought, _so this protocol is something Starfleet doctors know about. That means I just need to find one willing to explain what it is._ She had already looked up Katherine Pulaski, the doctor Admiral Brooks had mentioned. He was right, she had died — a transporter accident a year ago, a six-person away team, all lost in the pattern buffer. But, could something in Pulaski’s service record be a clue to finding another doctor who might be able to help?

“Now that’s odd,” Janeway said out loud as she leaned closer to her computer screen. Katherine Pulaski had served as chief medical officer on the Enterprise-D, preceded by Beverly Crusher and followed by Beverly Crusher. Could the two doctors have shared similar values? Janeway researched Crusher: an internship on Delos IV, postings to various starships, a year on the Enterprise-D, then a year at Starfleet Medical, then more years on the Enterprise-D and Enterprise-E. Her performance reviews were consistently high, with positive notations for medical ethics. Janeway searched for Crusher’s current location. Shore leave — in France! _What are the odds she would be on Earth?_ Janeway thought. She was about to open a channel to Crusher when Janeway realized it was nearly midnight in France. “Sleep well, Dr. Crusher,” Janeway said to the service record photo on her computer. “I look forward to speaking with you tomorrow.”

***

The next morning at 0800 hours San Francisco time, Janeway put through the audio-only call.

“Crusher here,” came a response.

“Dr. Crusher, I hope I’m not disturbing your shore leave. This is Admiral Kathryn Janeway from Starfleet Command. I was hoping to ask you a question.”

“Yes, Admiral.”

“What is the Dismissed Protocol?”

Janeway thought she heard a rustling on the line.

“I’m sorry, Admiral,” Crusher said. “I thought Admiral Brooks was the only medical admiral in Starfleet.”

“Dr. Crusher, I know we haven’t met, but I’m not going to lie to you. I’m not a medical doctor. I’m a scientist who can’t stand a mystery, and that’s just what this protocol seems to be.” 

“Hold on, please.”

Janeway was sure she heard rustling, as if Dr. Crusher was muting and then unmuting her comm badge.

“Admiral, is this a secure channel?”

“Yes, I did take that precaution due to a strange conversation with another doctor.”

There was more rustling and then Crusher said: “Could you come to France, Admiral? Alone?”

“I’ll be there in an hour. Just send me coordinates.”

From her computer, Janeway canceled her morning meetings, reserved a shuttle, and entered the coordinates into its navigation system. She hurried to Starfleet Command’s shuttlebay and politely informed the attendant her mission was classified. Soon, she was over North America, then the Atlantic Ocean, then France. She made a low descent across vineyards and settled on a grassy area. A woman who looked like Crusher’s service record photo walked out the front door of a chateau. Janeway stepped onto the soft earth.

“Thank you for coming, Admiral Janeway,” Crusher said.

“I appreciate your willingness to talk to me, Dr. Crusher.”

“Let’s go inside.”

The two women sat across from each other at a wooden table. Light streamed in from a nearby window. Crusher had offered coffee and Janeway had gratefully accepted. They both sipped from their mugs and Janeway began.

“There’s a lot of classified information at Starfleet Command, but I’ve never seen anything like this. Admiral Brooks thought I was a woman by the name of Katherine Pulaski and he was so angry I thought he was going to jump out of his skin. I tried every database I could to find this information before troubling you, but I don’t know many medical doctors and the one I consulted couldn’t help me.”

“Which Starfleet doctor did you consult?”

“He’s an EMH.”

“Oh, those things.” Crusher waved her hand dismissively. “I read about the one from your ship that was in the Delta Quadrant and I’m sure he’s an exception, but most of them are arrogant and rude.”

“Sounds about right, but he has other, more positive traits as well,” Janeway said and took another sip of her coffee. “But I think you’re stalling, doctor. What is the Dismissed Protocol?” 

Crusher held onto her coffee mug with both hands. “I checked and re-checked your credentials the entire time you were en route from San Francisco. I mentioned your name to people I trust, and they said I could trust you. I could lose my medical license if you tell anyone I told you about this, but, since you already know it exists, I’m hoping you’ll be able to offer me additional perspective on the protocol.”

“I’ll do what I can, but first I need to know what we’re talking about.”

There was a silence. Then, though it was shaky at first, Crusher’s voice gained strength as she spoke: “The Dismissed Protocol is the last lesson before graduation from Starfleet Medical and the only one doctors must vow to keep secret. The protocol began due to events on stardate 3418.5. Following a mission to Omicron Ceti III, five crewmembers of the U.S.S. Enterprise were found to be in very early stages of cyesis.”

“Five crewmembers, all pregnant at the same time?” Janeway asked.

“Yes,” Crusher said. “All as a result of sexual encounters while under the influence of mind-altering spores. By this time, the effect of the spores had abated, and the ship’s doctor informed the first crewmember of her condition. According to the lesson taught at Starfleet Medical, the crewmember became hysterical and was sedated. The doctor made the decision to terminate her pregnancy and those of the other four crewmembers. When the first crewmember came out of sedation, the doctor informed her he had been mistaken and she was reported to be much relieved and eager to return to her duties. The doctor never told the other four crewmembers. The Dismissed Protocol as it stands today calls for a Starfleet doctor to immediately dismiss, in other words, terminate, any pregnancy or possibility of pregnancy due to alien manipulation that compromised a crewmember’s mental or physical autonomy. The protocol pertains to all Starfleet personnel. Pertinent medical data is deleted and, if there is any bio-matter, it’s destroyed. Needless to say, the impacted crewmember is not informed.”

Janeway’s coffee had gone cold, but she held the mug tightly anyway. She refused to let her brain focus on anything but Crusher’s words. “Doctors throughout Starfleet implement this protocol?”

“Yes,” Crusher said. “The only doctor I know of who didn’t was Katherine Pulaski. I don’t know how she kept her Starfleet Medical license. Some doctors do what I do and pretend they missed the information on a scan and, when possible, try to determine from a conversation how the crewmember might react. But, that’s getting harder as the ship’s computer saves more information, even scans from medical tricorders. So, a lot of us are simply unusually aggressive about reminding crewmembers, even celibate ones, to keep up with their contraception injections.”

Crusher paused and then added: “I spent a year at Starfleet Medical fighting this policy as antiquated, insulting, and of deep concern to a crewmember’s right to self-determination. I lost, and I was sent back to starship deployment.”

“What did Starfleet Medical say about the rights of those impacted by the protocol?”

“That there has never been a complaint so there is no reason to revise the protocol.”

“How could there be a complaint if no one knows about the protocol?”

“Bingo.”

Janeway carefully placed her coffee mug on the table. “Do you mind if we step outside? I believe I need some air.”

“Not at all.”

The two women walked the dirt path that ran between vines of ripening grapes.

“Doctor, I’m deeply concerned by this information, and I hope you’ll give me some additional guidance.”

“Of course, Admiral.”

Janeway stopped, turned, and looked Crusher in the eyes. “How do I take this protocol and blow it up right in Starfleet Medical’s face?”

Crusher smiled broadly. “Call me Beverly.” 

“Kathryn.”

Now compatriots, they resumed their walk.

“Well, Kathryn, I’ve tried and failed to blow up this protocol. I bring it up at every medical symposium, still trying to affect change from the inside. But, some doctors think the protocol is a sensible policy.”

“How is that possible?”

“They say, for example, bodily takeover by an alien can be difficult enough to recover from without adding additional factors to a patient’s emotional or physical distress. One prominent physician, Dr. Yarro Geb, is Xyrillian and he deduced the protocol likely pertained to him early in his career. He‘s spoken at multiple symposiums describing his relief regarding his lack of knowledge at the time.”

“So, what was good for him is therefore good for everyone?”

“Dr. Geb may be one of a handful of people to even know the protocol affected their career, and none of those doctors have been willing to take the matter to arbitration.”

At Janeway’s request, Crusher explained how Starfleet Medical arbitration worked: A group of up to 50 doctors would gather to hear testimony from a doctor and from the patient seeking arbitration against that doctor. A medical arbitrator would lead the proceedings, then confer with four doctors, all randomly selected ahead of time from among the 50 in the audience. The arbitrator’s ruling would be binding upon the individual doctor as well as on any relevant policies, procedures, and protocols from Starfleet Medical. Arbitration was available at any medical symposium and the next symposium would be in a month, on Alpha Centuri.

“But, as I said before,” Crusher added, “this protocol has never gone to arbitration because patients don’t know it has affected them. Without a patient, there can be no arbitration.”

Janeway examined a grape leaf, then turned to Crusher. “There’s a chance I may be able to help you with that.”

***

As it began to get dark in the vineyard, Janeway called the EMH from the comm system of the parked shuttlecraft. Crusher sat in the neighboring seat, out of range of the viewscreen.

“Admiral,” the EMH said, his usual enthusiasm tempered by wariness. “I’m surprised to hear from you so soon.”

Exactly as she had been coached to by Crusher, Janeway said: “As per Starfleet Medical guidelines, I formally request Voyager EMH medical assessments of Kathryn Janeway from stardate 54622.6, give or take a few days.”

The Doctor glanced downward, then back at the viewscreen. “Patient presented with selectively manipulated memory engrams and limited understanding of personal history, rank, and function aboard starship. Patient appeared frightened, a quality not usually associated with said patient.”

“And?”

“Physician began treatment to restore patient’s memory. Estimated time to full recovery: 24 to 36 hours.”

“Doctor, under my medical rights you are required to tell me if I ask you directly — is there anything you assessed but didn’t include in your logs?”

“Is this a secure channel?”

“Yes.”

The Doctor’s eyes stayed downward for much longer this time. “Information not entered into patient record but stored in EMH memory: Patient uterus and Fallopian tubes contained unknown gelatinous substance. Unknown substance lacked its own genetic material, but appeared to be in the early stages of transforming two of patient’s own ovum to genetically combine. Suspected sexual contact with a species that procreates without use of paternal chromosomes. Patient’s memory engrams had been compromised for approximately three weeks. Substance estimated to be fewer than three weeks old. Dismissed Protocol activated.”

“Thank you, Doctor,” Janeway said, her voice clipped. “I’ll see you at arbitration.”

***

Over the next month, Crusher and Janeway exchanged encoded text communiques about their progress. Janeway formally requested the arbitration and it was scheduled for the symposium on Alpha Centauri. The official description for the arbitration did not include Janeway’s name or rank, but, as Crusher had predicted, the information became widely known among physicians within days. Meanwhile, Crusher was already established in Starfleet Medical circles as an assertive critic of the protocol, so she encouraged Starfleet doctors to sign a petition supporting the patient bringing arbitration regarding use of the Dismissed Protocol. The petition wouldn’t impact the arbitrator’s decision, but substantial peer opinion on the topic could sway the doctors who would consult with the arbitrator. Crusher also worked quickly to secure a seat as one of the 50 doctors who would watch the arbitration, though she received official notice she would not be a consulting doctor on the ruling.

The Dr. Geb that Crusher had warned Janeway about as a staunch supporter of the Dismissed Protocol sent around his own petition. But, as Crusher was pleased to inform Janeway, Geb’s petition had a hundred signatures, while Crusher’s petition had more than five hundred.

In one encoded text communique, Crusher asked Janeway how she felt about the upcoming arbitration.

 _I know the secrecy over the protocol means you can’t talk to anyone else about this_ , Crusher wrote. _I’m available if you want me to listen as a doctor and I’m available if you want me to listen as a friend._

Janeway reread that message a few times before she replied in a text communique she didn’t think she would actually send until she did.

 _His name was Jaffen_ , she typed, _and he worked with me at a power distribution facility. Me? Maybe not me. I knew my name, but my memories were a swindler’s fiction, and I certainly had no idea I was a starship captain. Oh, but we talked and we laughed and ... well, clearly the medical information indicates what else we did. It was exhilarating being in love. Finding out who I really was felt like the theft, even though I somehow knew I had it backwards. If I had I been aware of the physical ramifications of my choices during that time, I absolutely still would have left with my crew. Other decisions would have been more complicated. I find myself contemplating what those decisions might have been had I been entrusted to make them.... I realize the Dismissed Protocol pertains to events significantly more traumatic than those I’ve described here. But, the uniformity and secrecy of the protocol’s application despite the staggeringly complex and varied situations for which it has been applied means I simply cannot allow Starfleet Medical to let this continue._

Crusher sent a long, heartfelt reply that concluded with: _You don’t have to do this. But, the fact that you are choosing to take a stand on behalf of all Starfleet officers — I hope it brings some comfort in a painful time._

***

The arbitration was in a windowless conference room. The arbitrator’s seat was closest to the door. Then, two chairs about three meters apart faced each other. One chair was for the doctor under arbitration and the other for the patient bringing the arbitration. On the other side of those two chairs were 50 more chairs arranged in rows facing the arbitrator. The morning of the EMH’s arbitration, the 50 chairs were filled a half hour before the proceeding began. Crusher was in the front row.

At 0700, the arbitrator strode in, followed by Janeway and the EMH. The arbitrator took his seat and read Janeway’s two-sentence request for arbitration: “Administration of Dismissed Protocol infringes upon Starfleet’s fundamental duty to truth. Request for protocol to be discontinued in cases where Starfleet officer has or will soon regain mental faculties, as exemplified in case submitted.” He then read the EMH’s medical summaries from the relevant stardate, both the information in the medical log and the findings relevant to the implementation of the Dismissed Protocol. The arbitrator then asked the doctor and patient for testimony to clarify their need for arbitration so the doctors present could clearly understand the situation and medical concerns therein.

“This is difficult for me because I had to carry out the protocol,” the EMH began. “I had no choice; my programming demanded it.”

“No,” Janeway snapped. “You don’t get to have rights when you want them and then fall back on your programming as an excuse when it’s easier. You made a medical decision and this isn’t personal, this is professional. This is about the ethics of secrecy. If doctors felt the Dismissed Protocol was worthy, they wouldn’t hide it from their patients.”

The EMH hesitated. “A doctor’s first duty is to do no harm. Informing patients who were recently mentally compromised of further ... complexities ... could result in undue emotional harm.”

“Doctor,” Janeway said. “Had you ever discussed this protocol with anyone prior to my asking you about it?”

“As the only Starfleet doctor in the quadrant, I didn’t have that opportunity for the first seven years my program was running. Since returning to the Alpha Quadrant, I’ve been working with Starfleet Medical to showcase my many medical innovations. So, no.”

“So, your installed ethical subroutines were never challenged on this issue?”

“That’s correct.”

“And now that they have been?”

The Doctor hesitated. “I’m ... uncertain.“

“Good,” Janeway said. “Thoughtfulness is what happens when people discuss difficult topics. Giving full information to patients who have or will soon regain their memories allows those patients to regain that much more of their own self-determination. Let’s be honest here, Doctor. This Dismissed Protocol was never about dismissing the result of mental or physical circumstances that range from disquieting to appalling. The Dismissed Protocol is about dismissing patients, dismissing Starfleet officers you’ve disempowered in the misguided belief they aren’t capable of making their own decisions. If people can think, let them think.”

The EMH didn’t say anything else and Janeway felt the silence fill the room.

The arbitrator leaned back in his chair. “I’ll meet with the four-doctor panel and we will announce when this arbitration will reconvene.”

***

Crusher met Janeway outside the arbitration room.

“Your statements were expressed beautifully,” Crusher said.

“But will it be enough?” Janeway asked.

Crusher shook her head. “I can’t tell. So much of this could depend on which doctors confer with the arbitrator. I saw physicians in the audience who have spoken on opposing sides of the debate.”

A wiry Xyrillian approached them.

“You must be proud of yourselves,” he said, addressing Janeway and Crusher. His voice dripped with hostility.

“And you must be Dr. Yarro Geb,” Janeway replied, matching his tone word for word.

“If you win this, a lot of people will suffer.”

Crusher interjected. “A lot of people have suffered, Dr. Geb. They’ve suffered the indignity of a lie of omission. They’ve suffered from doctors who were prevented from counseling patients capable of making their own choices.”

“No,” Geb argued. “Starfleet officers want to feel proud to explore space, not be burdened by the evidence of a violation of their mental or physical self. And what about the patients who can’t make a decision due to mental incapacitation?”

“That part of the protocol wasn’t within the scope of this particular arbitration,” Janeway said evenly.

Geb turned to face only Janeway. “How did you find out about the Dismissed Protocol?”

“I can’t tell you,” she replied contemptuously. “Doctor-patient confidentiality.”

“I wouldn’t be surprised if it was her,” he motioned to Crusher, “which means I can bring her up on charges.”

“Oh, I wouldn’t waste your time with that, doctor,” Janeway said. “I’ll go to prison for lack of cooperation with a Starfleet investigation before I would ever reveal my source. I’m sure you would much rather spend time with your patients than sit in a courtroom.”

Geb addressed them both: “The protocol works! People crave the invisible forces that give their lives stability. You take that from them, and you clear the way for chaos and confusion. Anarchists like the two of you could break Starfleet. But you can’t see past your own noses.”

Geb turned abruptly and walked away.

Crusher turned to Janeway. “The good news is if he was talking to us, he’s not on the arbitration panel.”

“The good news,” Janeway countered, “is Starfleet is made of stronger stuff than Dr. Geb seems to think it is.”

***

It took four hours, but, finally, comm badges chirped with the message to return to the arbitration room. Doctors walked out of other symposium sessions to be there. Janeway and the EMH returned to their places in the opposing chairs. The arbitrator walked in, sat, and spoke.

“In consultation with the four-doctor arbitration panel, the arbitration decision is to retain the Dismissed Protocol.”

Crusher closed her eyes. Janeway gritted her teeth. The EMH stared at the floor. The doctors in the audience murmured.

The arbitrator continued: “However, the protocol is to be de-classified and shared with all Starfleet personnel, including those enrolled at Starfleet Academy. Every member of Starfleet, including cadets, will have the choice to opt in or opt out of the Dismissed Protocol, both at the time of enlistment and annually thereafter. Doctors will have the discretion to discuss options with patients. Starfleet Medical has three months to make these changes. This ruling is final.”

The arbitrator stood and left the room. The doctors exploded in conversation and debate. Janeway and the EMH warily approached each other.

“Admiral, I apologize,” the EMH said.

“Thank you, Doctor,” Janeway replied. “I meant it when I said this isn’t personal. I hope this experience has helped you grow as a medical ethicist, not just a physician.”

“Thank you, Admiral.”

Crusher rushed over to Janeway. “I’ve been trying for 25 years to get something like this done. Thank you!”

“I’m glad we accomplished what we did. Whenever possible, doctors deserve the opportunity to speak freely with their patients. Plus,” Janeway added with a smile, “now that the protocol is de-classified, I expect to see your work on this matter included in your application someday if you request a promotion to admiral.”

Geb stood in front of them. “I don’t see why you’re celebrating. The protocol is retained.”

“A celebration!” Crusher said, turning away from Geb, who strode off, aggrieved at being ignored. “Now that’s a good idea. Kathryn, let’s get a couple of glasses of wine.”

“Did you bring a bottle of Chateau Picard?” Janeway asked innocently. Crusher blanched. Janeway stifled a grin. “Beverly, a sign at the front of the property tells the name of the vineyard. Don’t worry, though, I won’t say a word.”

“Thank you,” Crusher said.

“So, let’s head over to the bar and raise a glass — to Katherine Pulaski; the old rabble-rouser would be proud of us today.”


End file.
